Healthcare Provider Details

I. General information

NPI: 1104179829
Provider Name (Legal Business Name): BAY RIDGE ENDOSCOPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2012
Last Update Date: 06/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

237 BAY RIDGE PKWY
BROOKLYN NY
11209-2403
US

IV. Provider business mailing address

237 BAY RIDGE PKWY
BROOKLYN NY
11209-2403
US

V. Phone/Fax

Practice location:
  • Phone: 718-833-5886
  • Fax:
Mailing address:
  • Phone: 631-264-2035
  • Fax: 631-264-1418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MAHER ALMOUDARRES
Title or Position: OWNER
Credential: M.D.
Phone: 718-833-5886